• C Vatier and N Bourcigaux.
• Service d'endocrinologie, diabétologie et endocrinologie de la reproduction, centre national de référence des pathologies rares de l'insulinosécrétion et de l'insulinosensibilité (PRISIS), hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, Paris, France; Inserm UMR_S 938, centre de recherche Saint-Antoine, Institut hospitalo-universitaire de cardiométabolisme et nutrition (ICAN), Sorbonne université, Paris, France. Electronic address: camille.vatier@aphp.fr.
• Rev Med Interne. 2023 Oct 1; 44 (10): 561566561-566.

AbstractWhile the prevalence of diabetes continues to rise worldwide, with 537 million adults aged 20-79-years-old having diabetes in 2021, the development of new therapeutic classes improving not only glycemic control but also kidney function and cardiovascular prevention has revolutionized patient care. Today, the treatment of diabetes is no longer just the treatment of blood sugar level. In this context, the individualized therapeutic strategy has been completely reviewed, with in particular sulfamides indicated much later in the therapeutic strategy, while SGLT2 inhibitors are indicated very early in patients with kidney disease and/or with ischemic heart disease or chronic heart failure, and GLP-1 analogues in obese patients and/or in primary or secondary cardiovascular prevention. As for lifestyle rules and metformin, they remain the cornerstone of treatment. Knowledge of antidiabetic effects in terms of efficacy and hypoglycemic risk, of cardiovascular, nephroprotective and weight effects is essential to optimize the management of diabetic patients today.Copyright © 2023 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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